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LETTER TO EDITOR Table of Contents   
Year : 2010  |  Volume : 53  |  Issue : 4  |  Page : 882-883
Ocular oncocytoma of the fornix


1 Department of Ocular Pathology, Dr. Rajendra Prasad Centre for Opthalmic Sciences, New Delhi, India
2 Department of Oculoplastics and Ocular Oncology, Dr. Rajendra Prasad Centre for Opthalmic Sciences, New Delhi, India

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Date of Web Publication27-Oct-2010
 

How to cite this article:
Kashyap S, Meel R, Bajaj MS, Pushker N. Ocular oncocytoma of the fornix. Indian J Pathol Microbiol 2010;53:882-3

How to cite this URL:
Kashyap S, Meel R, Bajaj MS, Pushker N. Ocular oncocytoma of the fornix. Indian J Pathol Microbiol [serial online] 2010 [cited 2019 Dec 11];53:882-3. Available from: http://www.ijpmonline.org/text.asp?2010/53/4/882/72034


Sir,

We present a case of oncocytoma, presenting as a mass in lower fornix of the eye, a rare site for an oncocytoma of ocular adnexa.

A 62-year-old lady presented with a slowly growing mass in lower fornix of right eye, which she incidentally noticed 3 months back. There was no pain or discomfort. On examination, the mass was smooth, round and pink in color and measured 8 × 10 mm in size. The lesion was completely excised under local anesthesia. Microscopic examination revealed conjunctival epithelium with a well-circumscribed lesion in the subepithelial stroma, which was comprising of cystic glandular spaces filled with eosinophilic debris [Figure 1]. These comprised of columnar cells with low nuclear cytoplasmic ratio. Nuclear atypia and mitotic figures were not seen. On higher magnification, the cells had abundant, finely granular cytoplasm [Figure 2]. The overlying stroma contained dense inflammation comprising of lymphocytes and plasma cells. The granular cytoplasm stained positive with periodic acid-Schiff stain [Figure 3]. Immunostains demonstrated uniform expression of cytokeratin. A histopathological diagnosis of benign oncocytoma was made.
Figure 1: Microphotograph showing a well-defined lesion in the subepithelial stroma with cystic glandular spaces filled with eosinophilic debris (H and E, ×40)

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Figure 2: High power view showing columnar cells full of abundant granular eosinophilic cytoplasm (H and E, ×400)

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Figure 3: Tumor cells showing positivity for periodic acid-Schiff stain (PAS stain, ×400)

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Oncocytomas or oxyphilic adenomas are benign tumors of transformed epithelial cells or oncocytes. Hamperl [1] gave the classic description of these cells in 1931. They are described as large polygonal cells filled with eosinophilic granules. Electron microscopy reveals cytoplasm packed with mitochondria of varying sizes and shapes with irregular and fragmented cristae. Oncocytoma occurs in various organs such as salivary gland, thyroid, adrenal gland, kidney, liver and breast. The first description of oncocytoma in ocular adnexa is credited to Radnot. [2] Since then, oncocytomas have been reported in the caruncle, lacrimal gland, bulbar and forniceal conjunctiva, lacrimal sac and eyelid margin. Caruncle is the most common site followed by the lacrimal sac. In fornix only two cases of oncocytomas have been reported in literature. [3] The oncocytoma in ocular adnexa may arise from the conjunctival epithelium, lacrimal sac epithelium, accessory lacrimal glands of conjunctiva, gland of moll in the eyelid skin and canalicular epithelium. It is believed that most of the ocular oncocytomas arise from oncocytic metaplasia of duct and acinar cells of lacrimal or salivary gland tissue located in the ocular adnexa. [3] Oncocytoma of fornix has not been reported before in Indian literature. Only one case of ocular oncocytoma, arising from caruncle, has been reported from India. [4] Forniceal oncocytomas, most likely, arise from accessory lacrimal glands of Krause [5] located at the fornices. Malignant transformation is rare with both local and distant spread. Treatment of choice is surgical excision. Though rare, oncocytoma of ocular adnexa should be recognized by the ophthalmologist because of its ability for malignant transformation.

 
   References Top

1.Hamperl H. Onkocyten und Geschwulste der Speicheldrusen. Virchows Arch Pathol Anat 1931;282:724-36.  Back to cited text no. 1
    
2.Radnot M. Aus Onkocyten bestehende adenomortige hyperplasie in der Transnensackwand. Ophthalmologic 1941;101:95-100.  Back to cited text no. 2
    
3.Biggs SL, Font RL. Oncocytic lesions of the caruncle and ocular adnexa. Arch Ophthalmol 1977;95:474-8.  Back to cited text no. 3
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4.Mohan ER, Biswas J, Krishnakumar S. Oncocytoma of the caruncle. Indian J Ophthalmol 2002;50:60-1.  Back to cited text no. 4
[PUBMED]  Medknow Journal  
5.Paretz WL, Ettinghausen SE, Gray GF. Oncocytic adenocarcinoma of the lacrimal sac. Arch Ophthalmol 1978;96:303-4.  Back to cited text no. 5
    

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Correspondence Address:
Seema Kashyap
Ocular Pathology Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi -110 029
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0377-4929.72034

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